Method, system, and program for electronically maintaining medical information between patients and physicians

ABSTRACT

Disclosed is a method, system, program, and data structure for maintaining electronic patient medical information. An electronic patient data structure is generated to include patient biographical information and one of medical history information, medication schedule information, and appointment schedule information. The patient data structure is electronically transmitted between a physician computer and a portable patient device. The patient data structure is capable of being modified.

BACKGROUND OF THE INVENTION

[0001] 1. Field of the Invention

[0002] The present invention relates to a system, method, program forelectronically maintaining medical information between patients andphysicians and, in particular, where the information is maintained in apatient data structure that may be communicated between a physiciancomputer and a patient device.

[0003] 2. Description of the Related Art

[0004] Providing health care to patients who require considerablemedical attention, such as elderly persons or those having debilitatingillnesses, can be problematic on many fronts. For instance, when thepatient visits a new physician, the patient must spend time filling outpatient medical and prescription history and insurance information. Forelderly or ill patients, this process can be difficult and often yieldsinaccurate or incomplete information. Further, the physician and staffmust spend considerable time questioning the patient on past symptoms,illnesses, and current medications and therapies. Again, if the patientis elderly or somewhat incapacitated, then they will likely not be ableto garner an adequate, let alone complete, picture of the patient'scurrent state. This failure to provide the treating physician completeinformation may cause the physician to misdiagnose the patient's problemor prescribe inappropriate or redundant medications and therapies.

[0005] Still further, an elderly or ill patient may have trouble keepingtrack of all the medication they must take and the schedule for theirmedication, as well as remembering all their medical appointments.Further, a care taker who is responsible for assisting a patient on adaily basis may have difficulty keeping track of all appointments andmedication schedules.

[0006] Currently, there are patient management database and schedulingsoftware products tailored for a physician's office that are used tomaintain patient information, including medical history, medicationhistory, insurance billing information, and visit scheduling. However,currently, such information is maintained solely by the physician andsuch electronic information is not communicated to the patient or otherphysicians treating the patient in a separate clinic.

[0007] For these reasons, there is a need in the art for an improvedpatient medical information system that allows patient medicalinformation, such as medical history, insurance information,prescription information, and visit scheduling to be effectivelycommunicated to the patient, the care provider for the patient, and thedifferent doctors and physician offices the patient must visit.

SUMMARY OF THE PREFERRED EMBODIMENTS

[0008] To overcome the limitations in the prior art described above,preferred embodiments disclose a method, system, and program formaintaining electronic patient medical information. An electronicpatient data structure is generated to include patient biographicalinformation and one of medical history information, medication scheduleinformation, and appointment schedule information. The patient datastructure is electronically transmitted between a physician computer anda portable patient device. The patient data structure is capable ofbeing modified.

[0009] In further embodiments, the portable patient device comprises aportable computing device including a display. Views of the patientmedication and appointment schedule information device stored in thepatient data structure are displayed in the display of the portablecomputing device to allow the patient to review scheduled medication andappointments.

[0010] In still further embodiments, log information is generatedindicating modifications to information in the patient data structure.The log information is read-only and once generated cannot be altered atthe physician computer or within the portable patient device.

[0011] Still further, the physician computer may add one of appointmentand medication events to the patient data structure. One appointmentevent indicates a scheduled visit at the physician office and onemedication event indicates a drug prescription. The physician computermay transmit the modified patient data structure to the patient device.

[0012] Preferred embodiments provide a medical information system thatallows a patient to maintain a patient data structure including detailedpatient biographical, insurance, and medical history information. Thisallows the patient to visit a physician's office for a first timewithout having to fill out the registration forms as all the informationthe physician needs is provided in the patient data structure, which iselectronically transmitted from the portable patient device to thephysician computer. Further, neither the patient nor physician have tospend time discussing the patient's medical history and currentmedications and therapies, as such information would be embedded in thepatient data structure. This not only saves time, but allows thephysician to provide a faster and more accurate diagnosis because thephysician has access to detailed medical history information. This isespecially important if the patient is physically or mentally impairedand cannot answer the physician's questions accurately.

[0013] Further, preferred embodiments provide medication and appointmentscheduling information which the patient can easily access to determinetheir medication and appointment schedule. The physician may access thepatient's medication and appointment schedules to determine currentmedications the patient is taking and the patient's schedule for thepurpose of avoiding scheduling a conflicting appointment or medication.

[0014] Still further, the use of the unalterable, read-only loginformation ensures data integrity because any attempts by either thepatient or physician to improperly modify patient medical informationare logged and, thus, can be detected.

BRIEF DESCRIPTION OF THE DRAWINGS

[0015] Referring now to the drawings in which like reference numbersrepresent corresponding parts throughout:

[0016]FIG. 1 illustrates a computing environment in which preferredembodiments are implemented;

[0017]FIG. 2 illustrates an arrangement of patient information in apatient record in accordance with preferred embodiments of the presentinvention;

[0018]FIG. 3 illustrates different displayed views of patientinformation from information maintained in the patient record inaccordance with preferred embodiments of the present invention;

[0019]FIG. 4 illustrates logic implemented in a patient computer andpatient personal digital assistant (PDA) device to manipulate and viewpatient information within a patient record in accordance with preferredembodiments of the present invention; and

[0020]FIG. 5 illustrates logic implemented in a physician computer tomanipulate and view patient information within a patient record inaccordance with preferred embodiments of the present invention;

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0021] In the following description, reference is made to theaccompanying drawings which form a part hereof and which illustrateseveral embodiments of the present invention. It is understood thatother embodiments may be utilized and structural and operational changesmay be made without departing from the scope of the present invention.

[0022]FIG. 1 illustrates a computing environment in which preferredembodiments are implemented. A patient portable personal digitalassistant (PDA) 2 is capable of communicating with a patient computer 4and with a physician computer 6 at the physician's office. The physiciancomputer 6 may be part of a local area network (LAN) at the physician'soffice that connects to a computer including a patient database. Thepatient PDA 2 may be any portable PDA type or similar device known inthe art, including palm and handheld PDAs, such as the PalmPilotproducts from 3COM.**, Hewlett-Packard Company's Jornada 820, 680/690and 430se, Psion Revo, IBM WorkPad, Cassiopeia from Casio Computer Co.,Ltd, etc.** The patient PDA 2 may include an interactive display as wellas an input technology, such as a pen stylus and touch screen displayinput, voice input, keyboard, displayed keyboard, etc.

[0023] The patient PDA 2 may establish communication links 8, 10 withthe physician 6 and patient 4 computers, respectively. The communicationlinks 8, 10 may be implemented using any PDA/computer communicationtechnology known in the art, such as infrared communication, serial,parallel, etc. For instance, the computers 4, 6 and patient PDA 2 mayinclude infrared communication ports to communicate data therebetween.Alternatively, a cradle capable of mating with the patient PDA 2 may beattached to the computers 4, 6 via a serial port. The patient PDA 2 maybe placed into the cradle to allow data transfer between the patient PDA2 and computers 4, 6.

[0024] The patient computer 4 includes patient desktop software 12, thephysician computer 6 includes physician software 14, and the patient PDA2 includes patient PDA software 16. These software programs 12, 14, and16 allow the sharing of medical information between a patient andphysician computing devices to facilitate the transfer of medicalinformation and assist the patient in maintaining scheduling ofmedication and physician visits. The physician computer 6 furtherincludes a patient database 18, which comprises database records for allpatients.

[0025] In preferred embodiments, patient medical information ismaintained as database records. FIG. 2 illustrates a preferredembodiment of a data structure for a patient record 18 i in the patientdatabase 18. The patient database 18 is comprised of patient records 18i for each patient the physician is treating. A patient record includesthe following fields:

[0026] Patient ID 20: Unique identifier of patient, such as socialsecurity number, providing the key column for patient records in thepatient database 18.

[0027] Patient Bio 22: This field is comprised of subfields includingbiographical information of the patient, such as full name, socialsecurity number, current address, sex, family contact information,insurance billing information, etc.

[0028] Medical History 24: This field is comprised of a string of one ormore medical event subrecords 24 a-24 n. A medical event subrecord iscreated upon the occurrence of a medical event, such as an illness,routine check-up or other event resulting in a consultation with aphysician. Each medical event subrecord would include fields for thedate of the medical event, diagnosis, prescribed medication,hospitalization, length of symptoms, outcome, treating physician, etc.

[0029] Medication Schedule 26: This field is comprised of a string ofone or more current prescription subrecords 26 a-26 n. A prescriptionsubrecord is created whenever a doctor prescribes medication. Eachprescription subrecord would include fields for the date ofprescription, dosage schedule, number of refills, prescribing physician,reason for prescription, and whether the prescription was filled andtaken as scheduled. Fields may also be maintained for the patient toindicate whether they took a dosage to allow both the physician andpatient to determine whether the patient has been taking the prescribedmedication. Further, there may be a pharmacist field indicating whetherthe subscription was filled. Still further an alarm function may beprovided to allow the patient to set an alert to activate at a scheduledmedication time and notify the patient of the scheduled event. Thisnotification function could use existing alarm functions in the system(e.g., patient PDA 2, patient 4 and physician 6 computers) or any otheralarm/scheduling software routine known in the art to schedule andgenerate an alarm notification. In preferred implementations, thepatient PDA software 16 could not modify the pharmacist field as well asthe information in the prescription subrecords 26 a-26 n entered by thephysician.

[0030] Appointment Schedule 28: This field is comprised of one or moreappointment subrecords 28 a-28 n. Each appointment subrecord includesfields for the date of the appointment, physician name, reason forappointment, etc. Again, an alarm function may be provided to allow thepatient to set an alarm to activate to alert the patient of a scheduledappointment.

[0031] Patient Log 30: This field is comprised of one or more logsubrecords 30 a-30 n. Each log subrecord logs any additions, deletionsor modifications to any field or sub-record of patient information. Eachlog subrecord indicates the date of change to the patient information,person or entity making change (e.g., patient or physician), key torecord being changed, and change made. All the software programs 12, 14,and 16 that are capable of modifying a patient record 18 i would includethe capability to automatically write an entry to the log recordwhenever information in the patient record 18 i is modified. Forsecurity reasons and to ensure the integrity of patient information,patient log records are read-only such that neither the physiciansoftware 14, patient desktop software 12, patient PDA software 16 norany other text editor or program can modify the log subrecords. Thisensures that no one can change any patient information without suchchange being recorded in an unalterable record. Thus, a doctor cannotalter the patient log 30 to reverse any wrongful entries nor can thepatient modify records to hide medical diagnosis, alter prescriptions,etc. This read-only feature of the patient log 30 ensures data integrityand accuracy of the information in the medical system.

[0032] The patient database 18 includes patient records 18 i formultiple patients. The patient PDA 2 and patient computer 4 wouldmaintain one patient record, including sub-records 20-30. Further,people may additionally store another person's patient record (e.g, achild, relative, friend, or recipient of paid-for-care) in their ownpatient PDA for convenience when acting as a care giver on behalf ofanother. The patient PDA 2 would communicate the patient record to thephysician computer 6 and patient computer 4 via the communication links8 and 10, respectively. The software programs 12, 14, and 16 provide thephysician and patient views to the information in the patient record andan interface to alter fields and sub-records of the patient record.

[0033]FIG. 3 illustrates the views that may be displayed in the patientPDA 2 by the patient PDA software 16 and how such views relate to thepatient record 18 i. Upon selecting the medical information programusing the patient PDA 2 graphical user interface (GUI), the patientwould view the main menu 40 displayed in the PDA 2 GUI window. From thismain menu 40, the patient may select one of five views: the patient bioview 42, the medical history view 44, the medication schedule view 46,the appointment schedule view 48, and the log view 50. Selection of oneof the five displayed options on the patient PDA 2 using a pen stylus orother input device would cause the selected view 42, 44, 46, 48, 50 tobe displayed on the patient PDA 2 display screen.

[0034] The patient bio view 42 displays subfields from the patient ID 20and patient bio 22 fields in the patient record 18 i. The medicalhistory view 44 displays the medical event subrecords in the medicalhistory field 24 of the patient record. The medical history view 44 mayprovide horizontal and vertical scrollable bars to allow the user toselectively scroll to view all the displayed fields in each medicalevent subrecords and all the medical event subrecords. The medicationview 46 provides a calender display of a medication schedule, i.e., whento take prescribed medication, which is derived from the prescriptionsubrecords 26 a-26 n in the medication schedule field 26 of the patientrecord 18 i. Next to each scheduled medication dosage is a check box,e.g., check box 52, in which the patient can indicate that they took thescheduled dosage. Further, an alarm can be set to activate at the timeof the scheduled dosage to alert the user of the scheduled event.

[0035] The medication view 46 shows a daily schedule of when to takemedicine during the indicated day. View 48 is an example of a weeklyview, in which a cell for each day of a week is displayed. The cellsthat include a block indicate a scheduled event, such as medication totake or a doctor appointment. Selection of the blocked cell may causethe display of a daily schedule providing further details of thescheduled event. A monthly schedule would provide a grid displaying acell for each day of the month. A marker would be placed in the cellindicating an event scheduled for that day. Selection of the day cellwould cause the display of a daily schedule providing details ofscheduled events for the day.

[0036] The appointment view 48 displays a weekly, monthly or dailyschedule of scheduled doctor visits that is derived from the appointmentsubrecords 28 a-28 n in the appointment schedule field 28. Again, analarm may be set to activate to alert the user of scheduledappointments, such as an alarm set a couple of hours prior to theappointment, the day before the appointment, etc. The log view 50displays the read-only log subrecords 30 a-30 n indicating changes madeto any of the other fields and/or subrecords in the patient record.

[0037] The patient desktop software 12 would include GUI panels to allowa user to modify and edit information in a patient record. Similarly,the physician software 14 would provide GUI panels to allow a member ofthe physician's staff to edit information in any field and/or subrecordof a patient record 18 i. As discussed, the physician computer 6maintains a patient database 18 including a plurality of patient records18 i. The physician software 14 may be used to edit any patient record18 i. Moreover, the physician software 14 may provide the display of anappointment schedule that displays scheduled appointments for allpatient records 18 i in the patient database 18. This would beaccomplished by locating in each patient record 18 i the appointmentsubrecord 28 i for that physician. In this way, the physician software14 may include a scheduling tool to allow the physician's staff tomanage appointments for all patients. The patient PDA software 16 wouldinclude the capability to allow a user to modify fields and/orsubrecords from the patient record 18 i displayed in the views 42-50using the patient PDA 2 input. As discussed, all the software programs12, 14, and 16 would automatically update the patient log 30 with anentry (log subrecord) whenever the patient or physician modify, add ordelete information in the patient record 18 i. Such log events cannot bealtered, thereby ensuring the integrity of the data in the patientrecords.

[0038] The medical event, prescription, appointment, and log subrecordsin the patient record 18 i may be generated at different physicianoffices, wherein the physician offices include an installed version ofthe physician software 14 to modify and manipulate patient records.

[0039] If the non-volatile storage of the patient PDA 2 is limited, thenit may not be possible to store all patient subrecords. In such case,using a criteria such as the age of subrecords or PDA storage capacityreaching a certain threshold, the patient PDA software 16 may prompt theuser to archive subrecords to ensure that the patient PDA 2 does not runout of storage. The patient may archive the subrecords in a portable,non-volatile storage medium, such as a floppy disk or specializedstorage module that is matable with the patient PDA 2. Alternatively,the patient may archive subrecords in the patient computer 4. In suchcase, the patient may provide the physician archived information on aseparate non-volatile storage medium or via e-mail from the patientcomputer 4 to provide the physician the complete patient medicalinformation.

[0040]FIG. 4 illustrates logic implemented in the patient desktopsoftware 12 to manipulate a patient record 18 i and, in particular,handle the display and modification of information displayed in theviews 42-50. The patient desktop software 12 would display in GUI panelson the display of the patient computer 4 the data displayed in the views42-50 described with respect to the patient PDA 2. However, when thepatient computer 4 is a desktop or laptop system, it has a display thatis capable of displaying more information than the patient PDA 2, andthus the layout of the views 42-50 would be different than the layoutshown with views 42-50 displayed on the patient PDA 2 as shown in FIG.3. With respect to FIG. 4, control begins at block 100 with the patientdesktop software 12 establishing a communication link with a patient PDA2 and downloading a patient record. A password may be required to accessa patient record. The patient computer 4 then reads the patient recordover the communication link 10 into memory. Alternatively, the patientdesktop software 12 may read the patient record from a storage locationin the patient computer 4. After reading the patient record 18 i intomemory, the patient desktop software 12 displays (at block 104) a mainmenu of selectable views, such as shown in main menu view 40 in FIG. 3.

[0041] Upon receiving a user selection of a view (at block 106), thepatient desktop software 12 (at block 108) accesses the fields and/orsubrecords from the field in the patient record corresponding to theselected view and displays the accessed information in a GUI interfacepanel of the patient computer 4 and awaits user input (at block 110). Ifthe user selected to exit the view (at block 112), then control proceedsback to block 104 to display the main menu of selectable views.Otherwise, if the user selected to modify a log subrecord 30 i or amedication quantity or dosage in a prescription subrecord 26 i (at block114), then the patient desktop software 12 would display (at block 116)an error message on the patient computer 4 display that the informationcannot be modified. Otherwise, the patient desktop software 12 performs(at block 118) the requested action, which may be to edit, modify, add,delete or further view information in the selected view being displayed.If the user action was to add, delete or modify any patient informationin the patient record 18, then a log subrecord is created and added (atblock 120) to the patient log 30 to log such change. From block 116 or118, control returns to block 110 to wait for further user action.

[0042] Also, at any time, the user at the patient computer 4 can updatethe patient record 18 i with any changes made. The patient computer 4can further transfer a modified patient record 18 i to the patient PDA 2for storage therein. The advantage of this approach is that the patientmay more conveniently edit patient information, such as the patient bio22 fields, at a desktop or laptop patient computer 4 than a patient PDAwhich typically has a limited input mechanism, as opposed to the fullkeyboard available with desktop and laptop computers. Another advantageof using the patient desktop software 12 is that in the event thepatient PDA 2 is lost or stolen, the patient would have a backup copy ofthe patient record 18 i in the patient computer 4 to upload into a newpatient PDA 2.

[0043] The patient PDA software 16 performs the same viewing operationsdescribed with respect to blocks 104-116 in FIG. 4 with respect to thepatient desktop software 12.

[0044]FIG. 5 illustrates logic implemented in the physician software 14to interact with the patient PDA 2 and obtain and update a patientrecord 18 i, and display views of the patient record. The physiciansoftware 14 performs many of the same operations as the patient desktopsoftware 12 to interact with the patient PDA 2 and display views of thepatient record 18 i, with a few exceptions. One difference is that whendisplaying the appointment view, the physician software 14 displays (atblocks 210 and 212) appointments in the subrecords for all the patientrecords 18 i in the patient database 18 as well as the appointments thecurrent patient has with other physicians. This ensures that thephysician staff member scheduling the appointment will not schedule anappointment that conflicts with appointments both the physician andpatient have already made. Further, unlike the patient software 12 and16, the physician software 14 allows the physician to modifyprescription subrecords 26 a-26 n to electronically write patientprescriptions. In further embodiments, the physician software 14 mayinclude the capability to digitally sign or encrypt a prescription withthe physician public key so that the pharmacist can authenticate anelectronic prescription within a prescription subrecord 26 a-26 nreceived from the patient PDA 2.

[0045] At any time the physician software 14 may update the patientdatabase 18 with any changes made to a patient record 18 i and thentransmit the updated record to the patient PDA 2.

[0046] There are many advantages to the medical information system ofthe preferred embodiments. First, is that a patient may use theubiquitous PDA device to maintain all the information needed to optimizea visit with a doctor. The patient PDA makes the first time visits to adoctor's office much easier because the patient does not have to fillout any forms. Instead, a communication link 8 is used to transmit theelectronic patient record from the patient PDA 2 to the physiciancomputer 6, without any involvement on behalf of the patient, exceptmaking the PDA 2 available. The physician's staff can then automaticallyobtain accurate personal and insurance billing information. This isespecially helpful if the patient is ill or injured and cannotaccurately respond or if the patient's care giver does not have suchinformation available. Still further the physician can obtain detailedpatient medical history, current prescriptions, and current scheduledmedical appointments without relying on the mental capacities of thepatient as such information is embedded in the patient record stored inthe patient PDA 2. This aspect is especially important because thephysician, by having accurate medical history and current treatmentinformation, will reach the correct diagnosis faster and avoidprescribing any treatments or medications that could be duplicative orharmful to the patient. Still further, the physician can be assured ofthe integrity of the information as any attempts by the patient tofalsify or improperly modify the medical history can be detected fromthe information displayed in the log view 50.

[0047] The advantages of the preferred embodiment medical informationsystem are numerous. No longer must a patient spend time filling outtedious and time consuming forms. Instead, all the patient must do isallow a communication link 8 to be established so the patient record 18i can be transferred from the patient PDA 2 to the physician computer 6.Further, if the patient has a complex medical illness requiring numerousmedications that may affect mental and memory capabilities, such as AIDSor cancer, then they may readily determine their medication schedule andany pending physician appointments from the medication 46 andappointment 48 schedule views. No longer must they remember to keep thehandwritten appointment reminder cards doctors provide, which areoftentimes lost or misplaced. Further, patients may download theirpatient record 18 i to a personal computer, i.e., the patient computer4, where they may review and edit their schedules 46 and 48 from theirdesktop or laptop at home or work. To interface with their medicalinformation, all they need do is install the patient desktop software 12on the desktop or laptop system. Further, they may want to use theirpatient computer 6, which typically has an easier to use inputmechanism, such as a full keyboard, to edit medical information.

[0048] The preferred embodiment medical information system is especiallyhelpful to care givers who provide daily assistance to a disabledpatient, such as an elderly or incapacitated person. Such patients areoften unable to have or remember all the information the physician'soffice needs. The PDA software 12 can provide substantial assistance tothe care giver in keeping track of all schedules appointments andmedications. Further, the care giver when taking the patient to a newdoctor need only make the patient PDA 2 available to electronicallytransfer the patient record 18 i to provide the physician's office withall the information they need to register the patient.

[0049] Moreover, by providing the check boxes with the medicationschedule view 46 to allow the patient to indicate that a dosage wastaken and the alarm notification for scheduled medication, the patientdoes not have to worry about forgetting whether they took all theirmedication. Further, the physician can review the check boxes todetermine whether the patient has in fact been taking their medication.

[0050] Insurance companies may also benefit from the preferredembodiment medical information system. To submit claims, all the patientor doctor need do is to electronically submit the medical event 24 isubrecord or prescription subrecord 26 i to the insurance company,thereby providing a paperless and automatic claim submittal system.Still further, the insurance company can detect fraud from discrepanciesin the patient and physician version of a patient record 18 i. Thisaspect of the preferred embodiments in improving efficiency to thephysician and insurance company in processing claims and patient medicalinformation, and in optimizing the patient registration and diagnosisprocess, will further reduce costs and improve both physician andinsurance company profitability and, at the same time, provide patientsbetter service.

Conclusion

[0051] The preferred embodiments may be implemented as a method,apparatus or article of manufacture using standard programming and/orengineering techniques to produce software, firmware, hardware, or anycombination thereof. The term “article of manufacture” (oralternatively, “computer program product”) as used herein is intended toencompass one or more computer programs and/or data files accessiblefrom one or more computer-readable devices, carriers, or media, such asmagnetic storage media, “floppy disk,” CD-ROM, optical disks,holographic units, volatile or non-volatile electronic memory, etc.Further, the article of manufacture may comprise the implementation ofthe preferred embodiments in a transmission media, such as a networktransmission line, wireless transmission media, signals propagatingthrough space, radio waves, infrared signals, etc. Of course, thoseskilled in the art will recognize many modifications may be made to thisconfiguration without departing from the scope of the present invention.

[0052] In the preferred embodiments, there were three describedcomputing devices, patient PDA, patient computer, and physiciancomputer. In further embodiments, additional computers may be added tothe system. For instance, the patient may maintain a smart card to storethe patient records. The physician would maintain a smart card reader toaccess the patient record in the card. In this way, if the patientcannot afford a PDA device, then the insurance company may provide asmart card to facilitate transfer of patient information to thephysician's office thereby improving physician efficiency and reducingcost overhead. Still further, the patient may maintain a smart cardreader at their computer to read information from the smart card to viewat their personal computer. Yet further, newer smart card devicesinclude limited displays. With such smart cards, the patient couldreview their medication and appointment schedule on the smart carddisplay. Thus, any portable electronic device capable of providingnon-volatile storage of a patient record may be used in place of thepatient PDA 2 for the patient to take to a physician office, includingthose that do not include a display.

[0053] Preferred embodiments described specific views of patient medicaland personal information as including specific fields of information.However, in alternative embodiments, different information may bepresented in the above described views and further views may be providedto provide alternative views of patient medical and personalinformation.

[0054] Preferred embodiments described the patient record as comprisedof fields, where the fields include further subfields and/or subrecords.However, those skilled in the design of database structures may realizethat alternative database structures may be provided to represent thepatient records. For instance, the patient record may be comprised ofkeys that index into other tables that include records for what is abovedescribed as included in a subrecord. For instance, a medical historytable may store zero or more medical event records for a single patientrecord, thereby providing a one-to-many relationship between eachpatient record and medical event records in the medical history table. Asimilar table arrangement may be provided for the medication scheduleand appointment schedule which is comprised of separate prescription andappointment records such that there is a relationship of patient recordsand prescription and appointment records in a medication and appointmenttables. In such alternative embodiments, a patient record is comprisedof multiple records, such as a patient bio record, and further recordsfor medical events, prescriptions, appointments, and log events.

[0055] The preferred logic of FIGS. 4 and 5 described specificoperations occurring in a particular order. In alternative embodiments,certain of the logic operations may be performed in a different order,modified or removed and still implement preferred embodiments of thepresent invention. Morever, steps may be added to the above describedlogic and still conform to the preferred embodiments.

[0056] In summary, preferred embodiments disclose a method, system, andprogram for maintaining electronic patient medical information. Anelectronic patient data structure is generated to include patientbiographical information and one of medical history information,medication schedule information, and appointment schedule information.The patient data structure is electronically transmitted between aphysician computer and a portable patient device. The patient datastructure is capable of being modified.

[0057] The foregoing description of the preferred embodiments of theinvention has been presented for the purposes of illustration anddescription. It is not intended to be exhaustive or to limit theinvention to the precise form disclosed. Many modifications andvariations are possible in light of the above teaching. It is intendedthat the scope of the invention be limited not by this detaileddescription, but rather by the claims appended hereto. The abovespecification, examples and data provide a complete description of themanufacture and use of the composition of the invention. Since manyembodiments of the invention can be made without departing from thespirit and scope of the invention, the invention resides in the claimshereinafter appended.

What is claimed is:
 1. A method for maintaining electronic patientmedical information, comprising: generating an electronic patient datastructure including patient biographical information and one of medicalhistory information, medication schedule information, and appointmentschedule information; and electronically transmitting the patient datastructure between a physician computer and a portable patient device,wherein the patient data structure is capable of being modified.
 2. Themethod of claim 1, wherein the portable patient device includes adisplay, further comprising: displaying, in the display of the portablecomputing device, views of the patient medication and appointmentschedule information stored in the patient data structure to allow thepatient to review scheduled medication and appointments.
 3. The methodof claim 2, further comprising: indicating, with the portable patientdevice, that one scheduled patient medication was taken; and storing theindication in the patient data structure that the patient took thescheduled medication in the patient data structure in the portablecomputing device.
 4. The method of claim 1, further comprising settingan alarm to activate to provide an alert of one scheduled patientmedication or appointment.
 5. The method of claim 1, further comprisinggenerating log information indicating modifications to information inthe patient data structure, wherein the log information is read-only andonce generated cannot be altered.
 6. The method of claim 1, furthercomprising: adding, with the physician computer, one of appointment andmedication events to the patient data structure, wherein one appointmentevent indicates a scheduled medical related visit and one medicationevent indicates a drug prescription; and transmitting the modifiedpatient data structure to the patient device.
 7. The method of claim 6,wherein the patient device includes a display, further comprising:displaying, in the display of the patient device, views of the patientmedication and appointment schedule information stored in the patientdata structure that were added to the patient data structure to allowthe patient to review scheduled medication and appointments.
 8. Themethod of claim 6, further comprising: storing, with the physiciancomputer patient data structures for multiple patients; displaying, atthe physician computer, an interactive schedule of patient appointmentsfrom appointment schedule information maintained in the patient datastructures, wherein appointment events are added to one patient datastructure through the displayed interactive schedule of patientappointments.
 9. The method of claim 1, wherein the patient datastructure further includes patient insurance billing information thatcan be used to generate insurance claims for patient services.
 10. Themethod of claim 1, further comprising using an additional computer tomodify information in the patient data structure and transmit themodified patient data structure to the portable patient device.
 11. Amedical information system for maintaining electronic patient medicalinformation for use in a physician computer and a portable patientdevice, the physician computer comprising: a computer readable mediumincluding an electronic patient data structure including patientbiographical information and one of medical history information,medication schedule information, and appointment schedule information;and at least one communication port capable of transmitting the patientdata structure to the portable patient device and receiving the patientdata structure from the portable patient device; and means for modifyinginformation in the patient data structure, wherein the modified patientdata structure is capable of being transmitted to the portable patientdevice via the communication port.
 12. The system of claim 11, whereinthe physician computer further comprises: means for displaying views ofthe patient medication and appointment schedule information stored inthe patient data structure to allow the physician to review scheduledmedication and appointments.
 13. The system of claim 12, wherein thephysician computer further comprises means for generating loginformation indicating modifications to information in the patient datastructure, wherein the log information is read-only and once generatedcannot be altered.
 14. The system of claim 12, wherein the physiciancomputer further comprises: means for adding one of appointment andmedication events to the patient data structure, wherein one appointmentevent indicates a scheduled medical related visit at and one medicationevent indicates a drug prescription; and transmitting, via thecommunication port, the modified patient data structure to the portablepatient device.
 15. The system of claim 11, wherein the physiciancomputer further comprises: means for storing patient data structuresfor multiple patients; means for displaying an interactive schedule ofpatient appointments from appointment schedule information maintained inthe patient data structures, wherein appointment events are added to onepatient data structure through the displayed interactive schedule ofpatient appointments.
 16. The system of claim 11, wherein the patientdata structure further includes patient insurance billing informationthat the physician computer uses to generate insurance claims forpatient services.
 17. A medical information system for maintainingelectronic patient medical information for use in a physician computerand a portable patient device, wherein the patient device includes:computer readable medium including an electronic patient data structureincluding patient biographical information and one of medical historyinformation, medication schedule information, and appointment scheduleinformation; and at least one communication port capable fortransmitting the patient data structure to the physician computer andreceiving the patient data structure from the physician computer,wherein the patient data structure is capable of being modified.
 18. Thesystem of claim 17, wherein the portable patient device furtherincludes: a display for displaying views of the patient medication andappointment schedule information stored in the patient data structure toallow the patient to review scheduled medication and appointments. 19.The system of claim 18, wherein the portable patient device furthercomprises: means for indicating that one scheduled patient medicationwas taken; and means for storing the indication in the patient datastructure that the patient took the scheduled medication.
 20. The systemof claim 17, wherein the portable patient device further comprises meansfor setting an alarm to activate to provide an alert of one scheduledpatient medication or appointment.
 21. The system claim 17, wherein theportable patient device further comprises means for generating loginformation indicating modifications to information in the patient datastructure, wherein the log information is read-only and once generatedcannot be altered.
 22. The system of claim 17, wherein the patient datastructure further includes patient insurance billing information thatcan be used to generate insurance claims for patient services.
 23. Thesystem of claim 17, further comprising an additional computer, whereinthe additional computer includes: means for transmitting the electronicpatient medical information between the additional computer and theportable patient device, wherein the additional computer is capable ofmodifying information in the patient data structure and transmitting themodified patient data structure to the portable patient device.
 24. Thesystem of claim 17, wherein the portable patient device comprises one ofa smart card, palm computing device, hand-held computing device, andlaptop computer.
 25. An article of manufacture for use in a medicalinformation system to maintain electronic patient medical informationfor use in a physician computer and a portable patient device, thearticle of manufacture comprising at least one computer program capableof causing the physician computer to perform: reading an electronicpatient data structure including patient biographical information andone of medical history information, medication schedule information, andappointment schedule information; and transmitting the patient datastructure to the portable patient device; receiving the patient datastructure from the portable patient device; and modifying information inthe patient data structure, wherein the modified patient data structureis capable of being transmitted to the portable patient device via thecommunication port.
 26. The article of manufacture of claim 25, furthercausing the physician computer to perform: displaying views of thepatient medication and appointment schedule information stored in thepatient data structure to allow the physician to review scheduledmedication and appointments.
 27. The article of manufacture of claim 26,further causing the physician computer to perform: generating loginformation indicating modifications to information in the patient datastructure, wherein the log information is read-only and once generatedcannot be altered.
 28. The article of manufacture of claim 26, furthercausing the physician computer to perform: adding one of appointment andmedication events to the patient data structure, wherein one appointmentevent indicates a scheduled medical related visit and one medicationevent indicates a drug prescription; and transmitting the modifiedpatient data structure to the portable patient device.
 29. The articleof manufacture of claim 25, further causing the physician computer toperform: storing patient data structures for multiple patients;displaying an interactive schedule of patient appointments fromappointment schedule information maintained in the patient datastructures, wherein appointment events are added to one patient datastructure through the displayed interactive schedule of patientappointments.
 30. The article of manufacture of claim 25, wherein thepatient data structure further includes patient insurance billinginformation, further causing the physician computer to perform:accessing the insurance billing information from the patient datastructure to use in billing medical services to the patient's insurancecompany.
 31. An article of manufacture for use in a medical informationsystem to maintain electronic patient medical information for use in aphysician computer and a portable patient device, the article ofmanufacture comprising at least one computer program capable of causingthe portable patient device to perform: storing an electronic patientdata structure including patient biographical information and one ofmedical history information, medication schedule information, andappointment schedule information; and transmitting the patient datastructure to the physician computer; receiving the patient datastructure from the physician computer, wherein the patient datastructure is capable of being modified.
 32. The article of manufactureof claim 31, further causing the patient device to perform: displayingviews of the patient medication and appointment schedule informationstored in the patient data structure to allow the patient to reviewscheduled medication and appointments.
 33. The article of manufacture ofclaim 32, further causing the patient device to perform: indicating thatone scheduled patient medication was taken; and storing the indicationin the patient data structure that the patient took the scheduledmedication.
 34. The article of manufacture of claim 31, furthercomprising setting an alarm to activate to alert the user of onescheduled patient medication or appointment.
 35. The article ofmanufacture of claim 31, further causing the patient device to perform:generating log information indicating modifications to information inthe patient data structure, wherein the log information is read-only andonce generated cannot be altered at the physician computer or by thepatient device.
 36. The article of manufacture of claim 31, furthercausing the patient device to perform: transmitting the electronicpatient medical information to an additional computer, wherein theadditional computer is capable of modifying information in the patientdata structure and transmitting the modified patient data structure tothe portable device.